When a person ingests psilocybin, in any form, the effects can be unpredictable. Some people will feel no different than normal. Others find themselves in a state of emotional reflection, ranging from light to deep introspection. Yet some experience moments of fear, anxiety, or reliving past trauma. How may a facilitator assist a person experiencing this? Today, we want to cover some of the recommendations on “reassuring touch” rules to date.
The Oregon Psilocybin Advisory Board
As a reminder, since March 31, 2021 the Oregon Psilocybin Advisory Board has met monthly to develop regulations for the emerging psilocybin industry. There are five subcommittees of the board, which include: research, health equity, manufacturing, training, and licensing. Our own Mason Marks chairs the Licensing Subcommittee. All five subcommittees make recommendations to the greater Board and the OHA on rulemaking, per Measure 109.
“Reassuring Touch” in psilocybin administration sessions
“Reassuring touch” in practices similar to psilocybin services, such as therapy, has garnered attention as to the ethical and legal consideration of its use. Though psilocybin services are not strictly considered therapy, the Licensing Subcommittee discussed similar concerns about facilitators giving “reassuring touch” to clients.
Studies exploring psilocybin experiences have incorporated physical contact with participants, allowing monitors to hand a participant’s hand or shoulder when experiencing fear or anxiety. Reassuring touch has thus been implemented in psilocybin administration models, such as the Accept, Connect, and Embody model, which uses psilocybin to treat depression. While many find reassuring touch helpful, it is important to establish consent and preference from a participant prior to administering psilocybin.
Licensing Subcommittee discussion and recommendations on reassuring touch
The Licensing Subcommittee discussed this topic over several meeting last year. It began by incorporating reassuring touch into the informed consent requirements. Not only is informed consent prior to the administration session, it will allow the client to ask questions and discuss the topic with the facilitator. As a standardized document, the informed consent form will relieve ethical and legal concerns by limiting the scope of reassuring touch.
In general, there is a question as to whether a person legally “consents” to something while under the influence of a substance. For instance, if a person enters into a contract while intoxicated, and a court thus finds that person lacked capacity, the court may find the contract unenforceable. Similarly, if a psilocybin client consents to reassuring touch while in an altered state of consciousness, the client could subsequently argue there was no informed consent.
Thus, the Subcommittee recommended: facilitators may use reassuring touch, but only if the client gave informed consent prior the administrative session.
Aside from legal concerns, the Subcommittee discussed the unique vulnerability a client experiences while in an altered state of consciousness. As prior studies have shown, people experiencing psilocybin may find themselves in a deep state of emotional reflection. A facilitator is expected to assist clients during these moments and avoid exploitation or influence. Physical contact should be heavily restricted to only allow respectful, professional support.
Thus, the Subcommittee also recommended: if a client permits reassuring touch through informed consent, sexual or romantic touch will be prohibited. Any facilitator who violates will be penalized and may face license revocation.
